ARTHROLOGY: HISTORY, OBJECT OF STUDY, METHODS, TECHNIQUES - ANATOMY AND PHYSIOLOGY - 2024

The arthrology is the area of the anatomy that is responsible for the study of the joints and periarticular tissues. Joints are a set of concurrent tissues whose function is to form union links between various bone structures and cartilage, with movement or without mobility.

It studies from simple joints, in which only two bones or two cartilage are joined by a joint, to those more complex where more bone structures and also cartilage are compromised.

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Arthrology also analyzes the anatomical composition, physiology and all the abnormalities that the body's joints can suffer. Some diseases of interest such as arthritis, osteoarthritis and injuries such as sprains, torn tendons and ligaments have been of particular interest in medicine.

This area is also called syndesmology and is closely related to rheumatology, which focuses on the study of joint abnormalities.

History

Knowledge of joints and joint abnormalities has been known for quite some time. Many Egyptian mummies had joint abnormalities and even these diseases were treated since then.

In various writings, Hippocrates referred to joint diseases and the study of joints.

Since the beginning of the 20th century, the first technological advances were presented, which consisted in the adoption and adaptation of techniques such as laparoscopy and endoscopy to the internal study of the joints, for diagnostic, research and therapeutic purposes. Prior to this, the studies were carried out using surgical techniques.

In general, the first studies focused on the effects of some diseases on the integrity of the joints. Kenji Takagi is considered the founder of the arthroscopic discipline, conducting his first studies on the patellar joint and the effects caused by arthritis as well as a careful description of the joint.

Since 1932 and with the development by this author of the arthroscope, investigations of the shoulder, knee, spine and ankle joints were carried out and four years later the first internal images of the joints began to emerge.

What does arthrology study?

Arthrology, as noted above, is the study of all joints present in the body as well as accessory structures and attached tissues.

The joints are together, the hard and soft parts that join the bones together as links. As a consequence of this, the latter, together with the musculature associated with them, can generate more or less wide movements or, on the contrary, keep the bones immobile.

There are several types of existing joints that are of equal interest in medical arthrology. These are classified according to the range of movement that the articulated bones present, in: diarthrosis, amphiarthrosis and synarthrosis.

Diarthrosis

These joints are also called true or moving joints. Diarthroses are those joints that have a wide capacity for movement. Two main types are recognized, simple diarthroses made up of two joint surfaces and complex diarthroses made up of several joint surfaces.

In ordering these joints, the articular faces, the articular cartilages, the articular capsule, the ligaments, the articular discs or menisci, and the marginal cartilage come into play.

These cartilages have two faces, the first one that is firmly attached to the bone, while the other face is free and bathed by a liquid called synovium, which secretes a specialized membrane (synovial membrane) that lines the inner surface of joints of this type..

These articular surfaces and their cartilage are covered by a single capsule, which is a very resistant fibrous and cylindrical sheet that is in turn protected by ligaments of different thickness and synovial fluid.

These include the shoulder, head, hip, and jaw joint. In this case, the articular surfaces tend to be spherical (concave or convex) or even flat, always covered by a cartilaginous tissue that will prevent wear.

Amphiarthrosis

These joints have limited movement or slight mobility. The segments are joined directly by a sheet of fibrocartilaginous tissue and by ligaments.

Its movement is directly determined by the shape of the articular surface and by the degree of flexibility of the means of attachment. These types of joints do not have a joint cavity or capsule and if they do, it is very rudimentary.

Here are the joints of the vertebral bodies, joined together by a fibrocartilage, the joints of both pubic bones (symphysis), the junctions of the metacarpal bones of the forelimbs and at the intersections of the cartilage of the ribs (syndesmosis).

In general, these types of joints are quite reinforced on the outside by various ligaments.

Synarthrosis

They are those with less or no mobility, the segments are joined by fibrous or cartilaginous tissue or a mixture of both, in such a way that movement between both segments is impeded. For this reason, they are called fixed or immobile joints.

The classic type of this type of joint is the bones of the skull and face except for the joint from the jaw to the temporal. These bones join at their edges, between which there is cartilaginous tissue in the child that later disappears as they mature and grow.

The articular surfaces have the shape of recesses and projections and are called sutures, which can be of different types, serrata, squamous and harmonic.

Joint Physiology

Joint physiology refers to all the movements that the joints allow the body to carry out hand in hand with the action of the muscles and the central nervous system.

Joint mechanics allows small, medium and large movements to be carried out, including flexion, extension, adduction, rotation, opposition, and the greatest of all, circumduction.

The joints are important not only in providing movement or a certain amount of it, they also provide flexibility to the body, also allowing interosseous connections.

Methods and techniques

A commonly used method of evaluating joints is arthroscopy. It is a relatively young technique in the medicine and study of joints, with the introduction of the first arthroscope consolidated in 1960 by Wantanabe and Takeda disciples of Takagi.

Initially it was used to study the largest joint in the body, the knee.

However, later, due to therapeutic results and technological advances, its use was extended to a larger set of joints. This technique has considerable advantages over others such as open arthrotomy as it is less invasive, and also allows a complete visualization of the joint and a general overview of its condition.

The complications that can arise from the arthroscopy method are minimal compared to other joint study methods. It is currently used in research and surgery of the knee, shoulder, hip, elbow, ankle, and wrist joints.

Arthroscopy as a research technique can be quite effective in accurately diagnosing abnormalities along with other tools such as MRI, radiology and physical examinations (palpation and observation), allow a detailed analysis of the joints.

Human arthrology

Muscles, ligaments and tendons, together with joints, allow the human skeleton to generate movements and people to move correctly. Specialists in the discipline (arthrologists) are responsible for evaluating various joint anomalies that go hand in hand with other disciplines such as rheumatology.

The diagnosis of degenerative diseases and the state of the joints are one of the study approaches of arthrology, in addition to the characteristics of a healthy and functional joint.

In general, the arthrologist treats joint inflammations with various origins, affecting the set of joint components from the synovium, the joint capsule and even the related cartilage and ligaments.

The tendons, ligaments, articular and periarticular bags and potentially compromised periarticular tissues are directly evaluated by the arthrologist.

Detailed knowledge of human joints has allowed the use of orthopedic implants in those joints that have suffered pronounced wear and tear from conditions such as arthritis and osteoarthritis. In this way, the normal functionality of the joint is restored.

Many prosthetics involve the knees, hips, shoulders, and elbows. Most of these medical advances are relatively recent since the late 20th century.

Animal arthrology

In animals, the study of the joints is of utmost importance both in anatomical classification and in their physiology. In veterinary sciences, it has a fundamental role in treating various diseases that present both used animals and pets as well as those of use in human activities.

In general, many of the advances and techniques developed in arthrology are based on animal experimentation.

Among the first investigations with the arthroscope, interventions were carried out on a horse with a chondral lesion. The latter produced good results and helped to improve the techniques used in the study of the joints and the equipment used then.

Animal arthrology is quite broad, as detailed knowledge of an animal's joints will largely depend on the species being investigated.

References

1. Ballesteros, JJC, Herrera, CJC, & Bono, AC (2002). General human anatomy (No. 59). Sevilla University.
2. Cirlos, GG, & Gutierrez, G. (1995). Principles of anatomy, physiology and hygiene: education for health. Editorial Limusa.
3. Done, SH, Goody, PC, Stickland, NC, & Evans, SA (2010). Color Atlas of Veterinary Anatomy: The Dog and the Cat. Barcelona: Elsevier.
4. Dufour, M. (2003). Anatomy of the locomotor system: osteology, arthrology, myology, fibrous system, neurology, angiology, morphotography (Vol. 1). Elsevier Spain.
5. Grossman, JD, & Sisson, S. (2000). Anatomy of domestic animals. Salvat.
6. Martínez Marrero, E. (2017). Arthrology. Northern University.
7. Miller, MD (1998). Magnetic resonance imaging and arthroscopy: correlation in joint pathology. Elsevier Spain.
8. Urroz, C. (1991). Elements of animal anatomy and physiology. EUNED.